奥氮平与利培酮对住院精神分裂症患者体重和脂代谢影响的比较  

Comparative of olanzapine and risperidone on body weight and lipid metabolism in inpatients with schizophrenia

作　　者：纪家武[1] 蒋昕[1] 陈华云[1] 郝楷荣[1] 陈艳丽[1] 陈旭先[1] 翁赛峥[1] 黄少雅[1] 林瑞钱 邓泓[1] 郭少楠[1] 谢懋平[1] 郑榕艳[1] 魏敏[1] 

机构地区：[1]福建医科大学福州神经精神病防治院,福建福州350008

出　　处：《中国新药与临床杂志》2013年第12期997-1000,共4页Chinese Journal of New Drugs and Clinical Remedies

基　　金：福建省医学创新课题资助(2009-CXB-38);福州市科技强院建设项目资助(2011-s-71-2)

摘　　要：目的比较奥氮平与利培酮对精神分裂症患者体重和脂质代谢的影响。方法100例精神分裂症患者随机分为奥氮平组（5～20mg·d-1）和利培酮组（1—6mg·d。），疗程8周，观察和比较两组患者第O、4、8周的体重、血糖、血脂水平。结果奥氮平组完成治疗46例，利培酮组完成治疗41例。治疗8周后，两组体重增加，三酰甘油（TG）、低密度脂蛋白一胆固醇（LDL—C）、总胆固醇（TC）升高，高密度脂蛋白一胆固醇（HDL—C）降低，较治疗前均有显著差异（P〈0．05）；奥氮平组体重增加和四项血脂变化均显著大于利培酮组（P〈0．05）；两组空腹血糖与治疗前无显著差异（P〉0．05）且均在正常范围内。奥氮平组女性患者体重增加大于男性（P〈0．05），利培酮对患者体重影响无性别差异（P〉O．05）：两组空腹血糖和四项血脂值变化无性，别差异（P〉0．05）。治疗4周后，奥氮平组患者体重的增加与TG增加值有显著相关关系（P〈0．05）。结论奥氮平与利培酮治疗对血脂、体重有影响，治疗后患者体重增加，TG、LDL—C、TC升高，HDL-C降低，且奥氮平的影响更大。奥氮平对女性患者的体重影响高于男性。AIM To compare the effects of olanzapine and risperidone on body weight and lipid metabolism in patients with schizophrenia. METHODS Totally 100 patients with schizophrenia were randomizely into olanzapine （5 - 20 mg＇d-l） group and risperidone （1 - 6 mg-d-1） group in the 8 weeks treatment. The body weight and serum levels of lipid were measured at baseline and 4, 8 weeks after the treatment. RESULTS The olanzapine group completed 46 patients and the risperidone group completed 41 patients. After the 8 weeks treatment, body weight increased, the serum levels of triglyceride （TG）, low density lipid-cholesterol （LDL- C） and total cholesterol （TC） increased significantly and high density lipid-cholesterol （HDL-C） decreased in the two groups compared with baseline （P 〈 0.05）. After the 8 weeks treatment, the olanzapine group had more body weight gain and bigger lipid changes than the risperidone group （P 〈 0.05）, and the fasting blood glucose in the two groups had no significant difference compared with baseline （P 〉 0.05） and belonged to the normal level. The body weight gain in female was more than that of male in the olanzapine group （P 〈 0.05） , while there was no gender difference in body weight gain in risperidone group （P 〉 0.05）. There were no gender differences in fasting blood glucose and lipid changes in the two groups （P 〉 0.05）. After 4 weeks of treatment, the body weight gain was significantly related to the changes of TG in the olanzapine group （P 〈 0.05） . CONCLUSION Olanzapine and risperidone can influence the serum level of lipid and body weight--body weight gained, TG, LDL-C and TC increased, and HDL-C decreased, which is more obviously for patients treated with olanzapine. Olanzapine has more influence on body weight gain for female patients than male patients.

关 键 词：奥氮平 利培酮 血脂 体重变化 精神分裂症 

分 类 号：R971.4[医药卫生—药品]